Provider Demographics
NPI:1124498217
Name:ZIGLEAR, DALE A
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:A
Last Name:ZIGLEAR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 COMMERCE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-1549
Mailing Address - Country:US
Mailing Address - Phone:407-450-5985
Mailing Address - Fax:407-604-6883
Practice Address - Street 1:303 COMMERCE CENTER DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-1549
Practice Address - Country:US
Practice Address - Phone:407-450-5985
Practice Address - Fax:407-604-6883
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2452106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist